Systematic review and meta-analysis of preoperative antisepsis with chlorhexidine versus povidone–iodine in clean-contaminated surgery

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British Journal of Surgery 2010; 97: 1614–1620

Background: Surgical-site infection increases morbidity, mortality and financial burden. The preferred topical antiseptic agent (chlorhexidine or povidone–iodine) for preoperative skin cleansing is unclear.
Methods: A meta-analysis of clinical trials was conducted to determine whether preoperative antisepsis with chlorhexidine or povidone–iodine reduced surgical-site infection in clean-contaminated surgery.
Results: The systematic review identified six eligible studies, containing 5031 patients. Chlorhexidine reduced postoperative surgical-site infection compared with povidone–iodine (pooled odds ratio 0·68,
95 % CI 0·50 to 0·94; P = 0·019) .
Conclusion: Chlorhexidine should be used preferentially for preoperative antisepsis in clean-contaminated surgery.

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